Midlands Living Center L L C
2452 North Broadway, Council Bluffs, IA 51503 · Pottawattamie County · (712) 323-7135
94 certified beds, about 70 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 2001
Certified for Medicaid Certified for Medicare
Overall
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
CMS Care Compare ratings, data as of September 1, 2026 · CCN 165447 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on January 8, 2026, inspectors cited 5 health deficiencies (the Iowa average is 6.5, the national average 9.2).
None of its 16 health citations since December 2023 was rated as actual harm or immediate jeopardy.
CMS lists no fines against this home in the last three years.
Nurses and nurse aides worked 3.78 hours per resident per day, against 3.82 across Iowa and 3.86 nationally. Registered nurses accounted for 0.65 of those hours.
40.8% of nursing staff left within the year CMS measured (Iowa average 44.0%).
Health inspections
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
412/23
109/24
501/25
104/25
501/26
Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit
Where its citations fall on CMS's grid
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 16 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
14D
2E
0F
Potential for minimal harm
0A
0B
0C
January 8, 2026Standard inspection · 5 citations
- E Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Inspectors wroteBased on record review, family interview and staff interview, and policy review the facility failed to maintain medical records on each resident in accordance with accepted professional standards and practices that are complete and accurately documented for 6 of 19 residents (Residents #11, #1, #13, #5, #67 and #71) reviewed. The facility failed to completely fill out the Medication Administration Record (MAR) - Treatment Administration Record (TAR) - Medication Monitoring (Med Mon) for the residents. The facility failed to accurately reflect the timeframe of assessments by late documentation entry. The facility had a census of 66.
- D Allow residents to self-administer drugs if determined clinically appropriate.
Inspectors wroteBased on direct observation, clinical record review, staff interview, and facility policy review, the facility failed to administer medication as prescribed and ordered by a physician when they allowed residents without an order to self-administer medication to do so (Resident #28, #34, #61). The facility reported a census of 66 residents.
- D Ensure services provided by the nursing facility meet professional standards of quality.
Inspectors wroteBased on clinical record review, hospital record review, resident interview and staff interview, the facility failed to obtain physicians orders for specific resident care and treatments for 1 of 17 residents reviewed. Resident #69 was admitted to the facility after heart surgery and was found to have significant edema (swelling) of his ankles and feet. Without obtaining a doctor's order, staff applied edema wear, compression hose, on bilateral lower extremities. The facility reported a census of 66 residents.
- D Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Inspectors wroteBased on clinical record review, resident interview, staff interview and facility assessment review, the facility failed to provide a consistent restorative program to ensure residents maintained the highest practical physical well-being for 1 of 2 residents reviewed. Resident #21 was participating in the restorative nursing program. In a six-week timeframe the resident was provided the exercises on 4 occasions with just one documented refusal. The facility reported a census of 66 residents.
- D Ensure that residents are free from significant medication errors.
Inspectors wroteBased on observation, staff interviews and policy review the facility failed to ensure residents were free of significant medication errors to 1 of 8 residents reviewed (Resident #18). The facility reported a census of 66 residents.
April 24, 2025Complaint inspection · 1 citation
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on observations, staff interview and facility policy review, the facility failed to maintain appropriate infection control practices for one of four residents reviewed (Resident #6). The facility reported a census of 68 residents.
January 15, 2025Standard inspection, Complaint inspection · 5 citations
- D Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Inspectors wroteBased on clinical record review, observation and staff interviews the facility failed to develop a comprehensive care plan related to the need for Enhanced Barrier Precautions (EBP) for 3 of 5 residents reviewed (Resident #29, #39 and #40). The facility reported a census of 63 residents.
- D Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Inspectors wroteBased on observation, staff interview and clinical record review the facility failed to update care plans for 2 of 17 residents. Resident #22 had edema, and Resident #12 was receiving antidepressant medications. These concerns were not addressed on the care plans. The facility reported a census of 63 residents.
- D Ensure services provided by the nursing facility meet professional standards of quality.
Inspectors wroteBased on observation, resident interview, staff interviews and clinical record review the facility failed to follow physician's orders for 3 of 17 residents. Residents #160 and #55 had orders directing staff to hold a medication when the Blood Pressures (BP) were outside of parameters. The medications were administered outside the established parameters. Resident #39 had an order for respiratory treatments via nebulizer three times per day and the facility failed to provide them as ordered by the physician. The facility reported a census of 63 residents.
- D Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on observation, interview and clinical record review the facility failed to provide safe transfer techniques for 1 of 3 residents reviewed. Staff D, Certified Nurse Aide (CNA) was observed to assist Resident #44 with ambulation without the use of a gait belt. The facility reported a census of 63 residents.
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on clinical record review, observation, staff interviews, and facility policy review the facility failed to use Enhanced Barrier Precautions (EBP) during catheter care for 1 of 3 residents reviewed for infection control (Resident #29). The facility reported a census of 63 residents.
September 30, 2024Complaint inspection · 1 citation
- D Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Inspectors wroteBased on observations, record review, facility investigative file review, staff interviews and policy review the facility failed to ensure 1 of 3 residents (Resident #2) was treated with dignity. The facility reported a census of 72 residents.
December 21, 2023Standard inspection · 4 citations
- E Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
Inspectors wroteBased on personnel file review, facility policy review and staff interview the facility failed to provide dependent adult abuse training within 6 months of hire for 1 of 5 employees reviewed (Staff A). The facility identified a census of 69 residents.
- D Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Inspectors wroteBased on clinical record review, staff interview, and policy review the facility failed to refer a resident to Preadmission Screening and Resident Review (PASRR) who was later identified to have a new diagnosis of delusional disorders for 1 of 3 residents reviewed (Resident #1). The facility reported a census of 69.
- D Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Inspectors wroteBased on clinical record review and staff interview the facility failed to revise and update care plans to include side effects to watch for with anticoagulant medication usage in 1 out of 17 sampled residents reviewed for comprehensive care plans (Resident #7). The facility reported a census of 69 residents.
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, document review, and staff interview the facility failed to provide appropriate infection prevention practices when completing blood glucose monitoring and disposing of a used needle. The facility reported a census of 69 residents.
Fines and payment denials
CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.
Staffing
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Iowa | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.78 | 3.82 | 3.86 |
| Registered nurses | 0.65 | 0.74 | 0.69 |
| All nursing staff on weekends | 3.27 | 3.37 | 3.42 |
| Nurse aides | 2.31 | ||
| Licensed practical nurses | 0.82 | ||
| Nursing staff turnover (share who left in a year) | 40.8% | 44.0% | 45.8% |
| Registered nurse turnover | 18.2% | 42.1% | 42.9% |
| Administrators who left | 0 |
CMS expects 3.37 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Staffing by quarter, from daily payroll records
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 3.98 on weekdays and 3.27 on weekends, 18% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.0% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.97 in April to June 2025 to 3.78 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 3.78 | 0.65 | 3.98 | 3.27 | 0.0% | 0 of 90 | 70 |
| Oct to Dec 2025 | 3.82 | 0.60 | 4.01 | 3.32 | 0.0% | 0 of 92 | 70 |
| Jul to Sep 2025 | 3.94 | 0.69 | 4.11 | 3.51 | 0.0% | 0 of 92 | 67 |
| Apr to Jun 2025 | 3.97 | 0.73 | 4.17 | 3.45 | 0.0% | 0 of 91 | 69 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Iowa, Jan to Mar 2026 | 3.80 | 0.71 | 3.98 | 3.36 | 4.7% | 0.3% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Staff pay reports
Staff pay at this home
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review.
Official wage estimates for Iowa
| Job | Median | Middle half | Employed |
|---|---|---|---|
| Iowa, all employers | |||
| CNAs (nursing assistants) | $18.92 | $17.96 to $21.95 | 22,670 |
| LPNs and LVNs | $30.11 | $27.12 to $34.06 | 5,510 |
| Registered nurses | $37.80 | $32.83 to $41.32 | 34,420 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
Quality measures
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Iowa | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 17.6 | 17.1 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 1.9 | 1.5 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 1.3 | 2.4 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 8.7 | 3.8 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.5 | 2.1 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 14.3 | 16.6 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 5.4 | 4.2 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 10.3 | 19.4 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 13.5 | 20.9 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 7.2 | 13.2 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 0.6 | 1.5 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 0.2 | 2.1 | 1.8 |
Owners and operators
Legal business name: MIDLANDS LIVING CENTER, L.L.P..
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Goracke, Douglas | 5% or greater direct ownership interest | Individual | 51% | 08/01/2003 |
| Chamley, Steven | Direct ownership interest | Individual | 01/01/2021 | |
| McCool, Jessica | Contracted managing employee | Individual | 04/01/2023 | |
| Busse, Tracy | W-2 managing employee | Individual | 09/01/2017 | |
| Tjaden, Jordan | W-2 managing employee | Individual | 10/01/2022 | |
| Goracke, Douglas | Corporate director | Individual | 09/23/2003 | |
| Chamley, Steven | Corporate officer | Individual | 01/01/2019 | |
| Goracke, Douglas | Corporate officer | Individual | 09/23/2003 | |
| Chamley, Steven | General partnership interest | Individual | 01/01/2019 | |
| Goracke, Douglas | General partnership interest | Individual | 09/23/2003 | |
| Chamley, Steven | Adp of the SNF | Individual | 12/17/2024 | |
| Goracke, Douglas | Adp of the SNF | Individual | 12/17/2024 | |
| McCool, Jessica | Adp of the SNF | Individual | 12/17/2024 | |
| Tjaden, Jordan | Adp of the SNF | Individual | 12/17/2024 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Questions to ask on a visit
Chosen from this home's own inspection record.
- When is the care plan meeting, and can family attend it?Inspectors cited 7 problems in this area, most recently on January 8, 2026: "Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards."
- What changed in infection control since the last inspection, and who on staff is the infection preventionist?Inspectors cited 3 problems in this area, most recently on April 24, 2025: "Provide and implement an infection prevention and control program."
- How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 2 problems in this area, most recently on January 8, 2026: "Allow residents to self-administer drugs if determined clinically appropriate."
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 2 problems in this area, most recently on January 8, 2026: "Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason."
- Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 3.27 hours per resident per day, below the Iowa average of 3.37.
Other nursing homes nearby
- North Crest Living Center Council Bluffs, 0.8 mi · 1 of 5 stars · 34 citations
- Bethany Lutheran Home Council Bluffs, 1.6 mi · 1 of 5 stars · 43 citations
- Prairie Gate Council Bluffs, 2.3 mi · 2 of 5 stars · 23 citations
- Chapters Living of Council Bluffs Council Bluffs, 3.9 mi · 1 of 5 stars · 68 citations
- St. Joseph Villa Nursing Center Omaha, 5.7 mi · 1 of 5 stars · 34 citations
- Ambassador Health of Omaha Omaha, 6 mi · 5 of 5 stars · 5 citations
- Emerald Nursing & Rehab Legacy Pointe LLC Omaha, 7.1 mi · 1 of 5 stars · 35 citations
- Florence Home Omaha, 7.2 mi · 4 of 5 stars · 15 citations
Iowa contacts for a concern about a nursing home
These are the official offices in Iowa. NursingHomeClear cannot take or act on complaints.
- Inspections and complaints: Iowa Department of Inspections, Appeals, and Licensing, Health Facilities, the state agency that inspects nursing homes for CMS and takes complaints about care.
- Resident advocate: Iowa Office of the State Long-Term Care Ombudsman, 866-236-1430. The long-term care ombudsman is a free, confidential advocate for residents and families, set up under the federal Older Americans Act.
- State inspection reports: Iowa Health Facility Database, Entity Search, where Iowa publishes its own records on licensed homes.
Common questions
- What is Midlands Living Center L L C's Medicare star rating?
- CMS rates Midlands Living Center L L C 4 out of 5 stars overall, with 3 for health inspections, 4 for staffing and 5 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Midlands Living Center L L C get at its last inspection?
- 5 health deficiencies at the standard inspection on January 8, 2026. The Iowa average is 6.5.
- Has Midlands Living Center L L C been fined?
- CMS lists no fines in the last three years.
- Does Midlands Living Center L L C accept Medicaid?
- It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
- Who owns Midlands Living Center L L C?
- CMS lists 14 owners and managers. Legal business name: MIDLANDS LIVING CENTER, L.L.P..
Sources
- Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
- Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
- Owners: CMS Ownership. Penalties: CMS Penalties.
- Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
- Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
- Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
- Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
- NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.